What is the 'tripledemic'? GP warns against three nasty viruses that have identical syptoms

The NHS is warning against a 'tripledemic' of viruses this winter. It comes as the rollout starts of Covid and flu vaccines in the north west for older adults, care home residents, and those with long-term health conditions, with over 2.8 million people eligible for the Covid-19 vaccine and 4.2 million for the flu jab.

This year's vaccinations aim to prevent a 'tripledemic' of RSV, Covid and flu which are already spreading. Typically, the flu season peaks in December and January, so starting adult vaccinations from October ensures that those most at risk are protected during the colder months when people gather indoors, and viruses spread more easily, says the NHS.

One GP has warned against the three viruses, which all have similar symptoms ."Each of these viruses can cause severe illness, especially in vulnerable groups like the elderly, young children, and those with weakened immune systems," the GP has said.

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Deaths from flu

New figures from UKHSA revealed that over the past two winters, there have been at least 18,000 deaths associated with flu and over 19,500 deaths associated with Covid-19 nationally.

Tricia Spedding, NHS England North West Head of Public Health, echoed Dr Charles-Ozuzu's sentiments, stating: "In recent years, we have had thousands of deaths associated with flu and Covid. We know this is something that vaccines are proven to help reduce and with winter fast approaching, where these viruses hit their peak, it is vital that anyone eligible for a vaccination, takes up the offer as soon as they can.

"We have over 230,000 appointments available in the coming week alone, with GP practices, pharmacies and other NHS teams offering quick and easy access to appointments, so if you have not booked yet then please do using the NHS website, NHS App, or by calling 119 it could keep you out of hospital this winter."

Very similar symptoms

"A ‘tripledemic’ refers to side-by-side outbreaks of three respiratory illnesses, typically occurring during the autumn and winter seasons," Dr Chun Tang, a GP at Pall Mall, told the Independent. "In recent years, it’s been used to describe the simultaneous spread of Covid-19, influenza (flu), and respiratory syncytial virus (RSV)."

"It is of particular concern now because, as these viruses circulate together, they can put pressure on the NHS due to a greater influx of patients," says Dr Tang.

"RSV, flu, and Covid share many overlapping symptoms like fever, cough, runny nose, and fatigue, which can make it difficult to tell the difference between them," notes Dr Tang.

What are the key differences to look for?

“Covid-19 may lead to a loss of taste or smell and more frequent breathing difficulties,” explained Dr Tang. “RSV often causes wheezing and is more likely to affect infants, while the flu tends to hit quickly with sudden fever and body aches.

“If you’re unsure, testing can confirm which virus is responsible.”

The GP encourages anyone whose symptoms become severe or worsen over time to contact their GP, especially if you have trouble breathing, persistent high fever, confusion, or chest pain.

“For infants, seek medical attention if they are struggling to breathe, are dehydrated, or if the child becomes unusually lethargic,” he said.

Can you get the viruses at the same time?

“Yes, it’s possible to contract more than one of these viruses together,” explains Dr Tang. “Being infected with multiple respiratory viruses can increase the severity of illness and make it harder for the body to recover, especially for those with weakened immune systems or existing health conditions.”

Who is most at risk?

The GP says that people most vulnerable to severe illness from a 'tripledemic' include young children, older adults, and individuals with underlying health conditions, such as asthma, diabetes, or weakened immune systems.

Babies under the age of one, especially those born prematurely, are at higher risk from RSV, while older adults and those with chronic conditions may face more serious complications from the flu and Covid-19, said the doctor. Vaccines will reduce the risk of severe illnesses.

Eligible individuals have been able to book vaccine appointments since Monday 23 September, and with 230,000 slots still available across the region, bookings can be made via the NHS website, the NHS App, or by calling 119 for free. The flu vaccine can also be booked by searching online for a local pharmacy, and walk-in sites are available for the Covid-19 vaccine.

Nationwide, the NHS has already invited over 11 million people to come forward, and GP practices and other local NHS services will also be contacting people to offer both vaccines. However, those who are eligible do not have to wait for an invitation to book.

Flu vaccinations for children and pregnant women began on 1 September, in an effort to prevent the virus from spreading as schools reopened.

Dr Linda Charles-Ozuzu, Regional Director of Commissioning for NHS England North West, has emphasised the importance of the winter vaccination programme. She stated: "The winter vaccination programme offers vital protection to people who need it most. It saves lives, but also it helps the NHS by reducing hospital admissions and easing pressure on services that are already incredibly busy."

She further urged those eligible, including individuals with certain long term health conditions, pregnant women, young infants and older people, not to delay getting their vaccines.

How do I treat myself if I get the illnesses?

“Flu and Covid-19 have antiviral medications available, but they work best when started early,” explains Dr Tang. “RSV typically requires supportive care, such as fluids, rest, and fever control, though severe cases in infants may require hospitalisation," says Dr Tang.

“For all three, the focus is on managing symptoms – hydration, rest, and medication to control fever and discomfort.

“Regular hand washing, mask-wearing in crowded places, and staying home when sick can help reduce the spread.

“Many older adults are at risk of vitamin D deficiency, particularly in winter when sunlight exposure is low. While vitamin D can help boost overall immunity, it’s not a specific treatment for these viruses.

“However, ensuring adequate levels through supplements or diet may help reduce the risk of respiratory infections.”

In line with advice from the Joint Committee on Vaccination and Immunisation, those eligible for a flu vaccine this year include:.

From 1 September:

• pregnant women
• all children aged 2 or 3 years on 31 August 2024
• primary school aged children (from Reception to Year 6)
• secondary school aged children (from Year 7 to Year 11)
• all children in clinical risk groups aged from 6 months to less than 18 years

From 3 October:

• those aged 65 years and over
• those aged 18 years to under 65 years in clinical risk groups (as defined by the Green Book)
• those in long-stay residential care homes
• carers in receipt of carer's allowance, or those who are the main carer of an elderly or disabled person
• close contacts of immunocompromised individuals
• frontline workers in a social care setting without an employer led occupational health scheme including those working for a registered residential care or nursing home, registered domiciliary care providers, voluntary managed hospice providers and those that are employed by Those who receive direct payments (personal budgets) or Personal Health budgets, such as Personal Assistants

The autumn Covid booster is available for:

• residents in a care home for older adults
• all adults aged 65 years and over
• persons aged 6 months to 64 years in a clinical risk group, as defined in the Green Book, including pregnant women
• frontline health and social care workers and staff in care homes for older adults